Provider Demographics
NPI:1699855502
Name:KASTNER, BRENDA K
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:K
Last Name:KASTNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 E ARAPAHOE RD
Mailing Address - Street 2:STE 150
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1279
Mailing Address - Country:US
Mailing Address - Phone:303-224-9920
Mailing Address - Fax:720-493-9566
Practice Address - Street 1:7400 E ARAPAHOE RD
Practice Address - Street 2:STE 150
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1279
Practice Address - Country:US
Practice Address - Phone:303-224-9920
Practice Address - Fax:720-493-9566
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC47403Medicare ID - Type Unspecified